Healthcare Provider Details

I. General information

NPI: 1093237455
Provider Name (Legal Business Name): OLIVIA ANNE STEPHENS ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/07/2017
Last Update Date: 07/07/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

251 MAITLAND AVE
ALTAMONTE SPRINGS FL
32701-4914
US

IV. Provider business mailing address

1183 SAWMILL CT
WINTER PARK FL
32792-8111
US

V. Phone/Fax

Practice location:
  • Phone: 407-915-5643
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberARNP9362944
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: